Soliman David, Naoom Rita, Zaied Mohamed, Soliman Samuel
Department of Embryology, Newlife Fertility Centre, Mississauga, Ontario, Canada.
Department of Obstetrics and Gynaecology, Brampton Civic Hospital, William Osler Health System, Brampton, Ontario, Canada.
F S Rep. 2024 Jul 4;5(4):356-362. doi: 10.1016/j.xfre.2024.06.006. eCollection 2024 Dec.
To compare in vitro fertilization treatment outcomes for the oral gonadotropin-releasing hormone (GnRH) antagonist elagolix (E) to the conventionally used injectable GnRH antagonist ganirelix (G) for achieving pituitary gonadotropin suppression during a controlled ovarian stimulation (COS) cycle.
Retrospective cohort study.
Private university-affiliated fertility center.
One hundred and ninety-four infertility patients receiving either E or G for pituitary suppression during the COS cycle.
Use of E for ovulation suppression during the COS cycle.
Biochemical pregnancy, sustained implantation, and cycle cancellation rates were the primary outcome measures. Secondary outcomes included miscarriage, fertilization, and blastulation rates.
The groups did not differ in their baseline demographic characteristics (age, body mass index, hormone profiles, total dosage of gonadotropins, number of oocytes retrieved, and number of embryos transferred). The overall cycle cancellation rates were 7.0% and 4.9% for e and G, respectively, and the difference was not statistically significant. For the frozen embryo transfers, the biochemical pregnancy, sustained implantation, and miscarriage rates for E were 74.5%, 51.0%, and 31.6%, respectively. For G, these were 55.9%, 39.8%, and 28.8%. Out of these outcomes, only the biochemical pregnancy rates were significantly different. For the fresh embryo transfers, biochemical pregnancy, sustained implantation, and miscarriage rates for E were 33.3%, 33.3%, and 0.0%, and for G, they were 37.5%, 25.0%, and 33.3%. None of the differences reached significance.
The oral GnRH antagonist, E, may be as effective as the injected antagonist, G, regarding embryological and clinical outcomes and could offer a less invasive, more cost-effective, and "patient-friendly" approach to pituitary suppression for in vitro fertilization treatment.
比较口服促性腺激素释放激素（GnRH）拮抗剂艾拉戈利（E）与传统使用的注射用GnRH拮抗剂加尼瑞克（G）在控制性卵巢刺激（COS）周期中实现垂体促性腺激素抑制的体外受精治疗结局。
回顾性队列研究。
私立大学附属生育中心。
194例在COS周期中接受E或G进行垂体抑制的不孕症患者。
在COS周期中使用E进行排卵抑制。
生化妊娠、持续着床和周期取消率是主要结局指标。次要结局包括流产、受精和囊胚形成率。
两组在基线人口统计学特征（年龄、体重指数、激素水平、促性腺激素总剂量、取卵数和移植胚胎数）方面无差异。E组和G组的总体周期取消率分别为7.0%和4.9%，差异无统计学意义。对于冻融胚胎移植，E组的生化妊娠率、持续着床率和流产率分别为74.5%、51.0%和31.6%。G组分别为55.9%、39.8%和28.8%。在这些结局中，只有生化妊娠率有显著差异。对于新鲜胚胎移植，E组的生化妊娠率、持续着床率和流产率分别为33.3%、33.3%和0.0%，G组分别为37.5%、25.0%和33.3%。差异均无统计学意义。
口服GnRH拮抗剂E在胚胎学和临床结局方面可能与注射用拮抗剂G同样有效，并且在体外受精治疗中对垂体抑制可能提供一种侵入性较小、更具成本效益且“患者友好”的方法。
